Temporärer Bauchdeckenverschluss und pathophysiologische Früh- und Spätfolgen der Behandlung eines offenen Abdomens

Jannasch, Olof; Tautenhahn, J.; Lippert, H.; Meyer, Freida

doi:10.1055/s-0031-1271347

Cited by 15 publications

(4 citation statements)

References 14 publications

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“…By a functional reconstruction of abdominal wall defects, e.g., using innervated muscle, abdominal wall is sufficiently resistant to pressure and tension. For defects of the lower abdominal wall, a pediculated rectus-femoris-muscle flap plasty is recommendable [ 38 , 40 – 43 ], particularly since morbidity of the flap mobilization is low. If a pediculated flap plasty in the required area cannot be performed, also free flap plasties are available, which can be used according to the defect site.…”

Section: Corner Pointsmentioning

confidence: 99%

“…Already the suspicion requires a prompt radical debridement, in the majority of cases, repeatedly added by intensive care and antibiotic therapy. After stabilization of general condition and wound situation, coverage of defects and reconstruction by plastic surgery techniques is sometimes required [ 18 , 37 , 40 , 45 ]. This includes mesh grafting, but also muscle or myocutaneous flaps.…”

Section: Corner Pointsmentioning

confidence: 99%

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Interdisciplinary aspects of abdominal and plastic surgery – what does the (abdominal) surgeon need to know?

Kraus,

Damert,

Meyer

2023

Innovative Surgical Sciences

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Introduction The aim was to reflect the established interdisciplinary aspects of general/abdominal and plastic surgery by means of a narrative review. Methods: (i) With specific references out of the medical literature and (ii) own clinical and perioperative as well as operating technical and tactical management experiences obtained in surgical daily practice, we present a choice of options for interdisciplinary cooperation that could be food of thought for other surgeons. Content – Decubital ulcers require pressure relieve, debridement and plastic surgery coverage, e.g., by a rotation flap plasty, V-Y flap or “tensor-fascia-lata” (TFL) flap depending on localization (sacral/gluteal defects, ischiadic tuber). – Coverage of soft tissue defects, e.g., after lymph node dissection, tumor lesions or disturbance of wound healing can be managed with fasciocutaneous or muscle flaps. – Bariatric surgery: Surgical interventions such as butt lift, tummy tuck should be explained and demonstrated in advance and performed commonly after reduction of the body weight. – Abdominoperineal rectum extirpation (APE): Holm’s procedure with greater circumferential extent of resection at the mesorectum and the insertion site of the levator muscle at the anal sphicter muscle resulting in a substantial defect is covered by myocutaneous flap plasty. – Hernia surgery: Complicated/recurrent hernias or abdominal wall defect can be covered by flap plasty to achieve functional reconstruction, e.g., using innervated muscle. Thus, abdominal wall can respond better onto changes of pressure and tension. – Necrotising fasciitis: Even in case of suspicious fasciitis, an immediate radical debridement must be performed, followed by intensive care with calculated antibiotic treatment; after appropriate stabilization tissue defects can be covered by mesh graft of flap plasty. – Soft tissue tumor lesions cannot be resected with primary closure to achieve appropriate as intended R0 resection status by means of local radical resection all the time – plastic surgery expertise has to be included into interdisciplinary tumor concepts. – Liposuction/-filling: Liposuction can be used with aesthetic intention after bariatric surgery or for lipedema. Lipofilling is possible for reconstruction and for aesthetic purpose. – Reconstruction of lymphatic vessels: Lymphedema after tumor operations interrupting or blocking lymphatic drainage can be treated with microsurgical reconstructions (such as lympho-venous anastomoses, lympho-lymphatic anastomoses or free microvascular lymph node transfer). – Microsurgery: It is substantial part of modern reconstructive plastic surgery, i.e., surgery of peripheral nerves belongs to this field. For visceral surgery, it can become important for reconstruction of the recurrent laryngeal nerve. – Sternum osteomyelitis: Radical debridement (eventually, complete sternal resection) with conditioning of the wound by vacuum-assisted closure followed by plastic surgery coverage can prevent chronification, threatening mediastinitis, persisting infectious risk, long-term suffering or limited quality of life. Summary The presented selection of single topics can only be an excerpt of all the options for surgical cooperation in daily clinical and surgical practice. Outlook An interdisciplinary approach of abdominal and plastic surgery is characterized by a highly developed cooperation in common surgical interventions including various techniques and tactics highlighting the specifics of the two fields.

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Section: Corner Pointsmentioning

confidence: 99%

Section: Corner Pointsmentioning

confidence: 99%

Interdisciplinary aspects of abdominal and plastic surgery – what does the (abdominal) surgeon need to know?

Kraus,

Damert,

Meyer

2023

Innovative Surgical Sciences

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“…A total of 35 articles discussed prophylactic VSD (pVSD) for abdominal incisions with primary suture, of which 6 were RCTs 32 , 33 , 34 , 35 , 36 , 37 and 29 were observational studies. 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 …”

Section: Recommendationsmentioning

confidence: 99%

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

Sun

et al. 2019

Chinese Journal of Traumatology

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Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2–4. Weak recommendations were made regarding questions 1 and 5–11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

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“…Sollte dies nicht ausreichen oder möglich sein, können auch Ersatzmatrizes zum Einsatz kommen [1]. Die Vakuumtherapie bietet sich als temporäre Deckung für geplante Rezidiveingriffe, zur Wundkonditionierung und auch -verkleinerung an [9][10][11][12]. Vor allem bei " Rezidivhernien, " Netzunverträglichkeiten, " frei liegenden Gefäßprothesen/-bypässen u. ä. ist eine interdisziplinäre Zusammenarbeit zwischen Viszeralund Gefäßchirurgen einerseits und plastischen Chirurgen andererseits sinnvoll.…”

Section: Diskussion !unclassified

Was der Allgemein-, Viszeral- & Gefäßchirurg über plastische Chirurgie wissen sollte – plastisch-chirurgische Aspekte in der Allgemein- & Viszeralchirurgie

et al. 2014

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There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

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Temporärer Bauchdeckenverschluss und pathophysiologische Früh- und Spätfolgen der Behandlung eines offenen Abdomens

Abstract: Type and severity of the various early and late consequences in the treatment of an open abdomen are substantially determined by the complication-inducing causes and the basic disease as well as by the options of an efficient, even in some cases temporary closure of the abdominal wall.

Cited by 15 publications

References 14 publications

Interdisciplinary aspects of abdominal and plastic surgery – what does the (abdominal) surgeon need to know?

Interdisciplinary aspects of abdominal and plastic surgery – what does the (abdominal) surgeon need to know?

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

Was der Allgemein-, Viszeral- & Gefäßchirurg über plastische Chirurgie wissen sollte – plastisch-chirurgische Aspekte in der Allgemein- & Viszeralchirurgie

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